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目的探讨较大剂量芬太尼在小儿麻醉中的可行性及其优点。方法 30例非开胸非开颅手术的小儿,采用非气管插管全身麻醉,麻醉方法按顺序依次肌内注射氯胺酮4mg/kg,静脉注射咪达唑仑2mg,分2次静脉注射芬太尼2μg/kg,术中45min后追加25μg,术中辅助丙泊酚维持麻醉。记录血压和心率波动、SpO2、呼吸频率、对手术刺激的肢体反应及丙泊酚用量。结果 30例患儿中优16例,良12例,差2例。优良率为93.3%。30例小儿麻醉丙泊酚的平均使用量约为9mg·kg-1·h-1。结论使用较大剂量芬太尼在小儿麻醉中可减少其他麻醉药物使用,从而减少麻醉并发症的发生。
Objective To investigate the feasibility and advantages of larger-dose fentanyl in pediatric anesthesia. Methods Thirty non-open-chest non-craniotomy children underwent non-tracheal intubation general anesthesia. The anesthetic method was followed by intramuscular injection of ketamine 4mg / kg, intravenous midazolam 2mg, and intravenous injection of fentanyl 2μg / kg, 45min after surgery additional 25μg, intraoperative propofol to maintain anesthesia. Blood pressure and heart rate fluctuations, SpO2, respiratory rate, limb response to surgical stimulation, and propofol dosage were recorded. Results 30 cases of excellent in 16 cases, good in 12 cases, poor in 2 cases. Excellent rate of 93.3%. The average usage of propofol in 30 children was about 9 mg · kg-1 · h-1. Conclusion The use of larger doses of fentanyl in pediatric anesthesia may reduce the use of other anesthetics, thereby reducing the incidence of anesthetic complications.